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Neil Resnick

University of Pittsburgh Researchers Present Findings at American Geriatrics Society Annual Meeting

PITTSBURGH, May 1, 2002 — Researchers from the Division of Geriatric Medicine at the University of Pittsburgh School of Medicine will present findings from several studies at the American Geriatrics Society Annual meeting in Washington,D.C., May 8-12. Presentations include the following:

CARDIOVASCULAR DISEASE LEADS TO MODESTLY HIGHER RISK OF DEMENTIA, ALZHEIMER'S DISEASE AND VASCULAR DEMENTIA

People with cardiovascular disease have a modestly elevated risk of developing dementia, Alzheimer's disease and vascular dementia, according to a study being presented May 9 at the annual meeting of the American Geriatrics Society in Washington, D.C.

"We found that those with cardiovascular disease had a modest increased risk of dementia of about 30 percent, only partially explained by stroke," said Anne B. Newman, M.D., M.P.D., a geriatrician at the University of Pittsburgh School of Medicine and an associate professor of medicine and epidemiology. "Although the relative risk was moderate, the high prevalence of cardiovascular disease coupled with the high incidence of dementia would yield a high attributable risk of cardiovascular disease as a cause of dementia."

The risk of vascular dementia was highest in those participants with peripheral artery disease. A very small, less than 20 percent, increase in the risk of Alzheimer's disease in those with cardiovascular disease cannot be ruled out. It is possible that the competing risk of death due to cardiovascular disease may be masking the effect of cardiovascular disease on the incidence of Alzheimer's.

RULES REGARDING TREATMENT OF URINARY INCONTINENCE AMONG NURSING HOME RESIDENTS SHOULD BE RE-THOUGHT

Current federal rules for treating urinary incontinence among nursing home residents should be re-thought, giving residents more freedom of choice, according to a study being presented May 9 at the annual meeting of the American Geriatrics Society in Washington, D.C. Treatment is currently mandated without asking residents, assuming they cannot reliably express an opinion, but that they desire the preventive methods.

University of Pittsburgh researchers, led by Neil Resnick, M.D., professor of medicine at the University of Pittsburgh and chief of the division of geriatrics, surveyed 80 nursing home residents to test their decision-making abilities and their preferences regarding the baseline requirement of regular toileting by nursing home staff.

They found that nearly three-quarters of the residents were capable of expressing an opinion about their treatment. Of this group, more than one-third would not desire the sometimes-intrusive incontinence care. By contrast, many would prefer a medication.

"Our survey showed that you cannot presume that the resident is incapable of expressing an opinion. The physician must discuss preferences with the resident and the family," said Dr. Resnick. "Guidelines should be re-thought rather than forced indiscriminately on residents and staff."

MEN ON ANDROGEN DEPRIVATION THERAPY FOR PROSTATE CANCER AT RISK FOR OSTEOPOROSIS

Men who are androgen deprived while undergoing treatment for prostate cancer for long periods may be at increased risk for osteoporosis-related injury, according to a study being presented May 10 at the annual meeting of the American Geriatrics Society in Washington, D.C.

Androgen deprivation is the most effective systemic therapy for prostate cancer, but long periods of hypogonadism are associated with an increased risk of osteoporosis and osteoporotic fractures, according to study senior author Susan Greenspan, M.D., professor of medicine in the divisions of endocrinology and metabolism and geriatric medicine at the University of Pittsburgh School of Medicine.

The study evaluated 96 men divided into four groups: men with no prostate cancer (control group), men with prostate cancer but no androgen deprivation, men with androgen deprivation for less than six months and men with androgen deprivation for more than six months.

Results of the study showed that androgen-suppressed men had a significantly increased percent of body fat compared with lean body mass, lower bone densities at all skeletal sites examined and higher levels of bone turnover markers compared to the healthy controls.

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